Medicaid is the federal government health insurance program for people in poverty. Before the Affordable Care Act (ACA) individuals qualified for this program if they lived at about 64% of the federal poverty level. In 2023 the federal poverty level is $13,590 for an individual. The ACA allowed states to expand eligibility for Medicaid to 138% of the federal level (about $18,754 for a single individual in 2023).
To date, forty states have expanded Medicaid. The states that did not adopt Medicaid are: Alabama, Florida, Georgia, Kansas, Mississippi, North Carolina, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming. South Dakota has adopted but not implement Medicaid expansion.
The American Rescue Plan Act (ARPA) of 2021 provided financial incentives for expanding Medicaid. The coronavirus pandemic adversely affected health outcomes through lack of access to healthcare and increased mortality. Coverage options for many low-income adults are limited in non-expansion states.